19/03/2008 A minor correction was made to the presentation of the Explanatory Notes within the datacube Deaths of Aboriginal and Torres Strait Islander people. A PDF version of the publication has also been added. Standardised death rates and Years of Potential Life Lost have been corrected throughout the chapter text and datacubes.

NOTES

Further detail in this publication can be found in the publication Contents, or alternatively a print-friendly PDF file can be found in publication Details.

REVISIONS OF CAUSES OF DEATH DATA

Coding of Causes of Death is currently undertaken within a specific timeframe using all information available at the time. However, not all relevant information is available to the ABS at cessation of processing (i.e. open coronial cases). The ABS currently does not revise Causes of Deaths death data, even if additional information becomes available.

The ABS is investigating possible options for introducing a revisions process for causes of death commencing with the 2007 reference year. A revision process would allow use of information to become available after the initial publication.

Initial consultation with major users has commenced. An information paper will be released prior to the publication of 2007 Causes of Death to inform users of the proposed strategy.

INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070.

SUMMARY COMMENTARY

DEATHS

As the Australian population continues to both increase in size and to age, the number of deaths registered each year continues to slowly increase. In the period 1997 to 2006, the population of Australia has increased 11.8%, and people aged 65 years and over made up 13.0% of Australia's population, compared to 12.1% in 1997.

There were 133,739 deaths registered in Australia in 2006, approximately 3,000 (2.3%) more than the number registered in 2005 (130,714). The standardised death rate in 2006 (6.0 deaths per 1,000 standard population) was the lowest on record, reflecting a steady decline in the standardised death rate over the past decade from 7.6 deaths per 1,000 in 1997.

Males accounted for 68,556 (51.3%) deaths registered in 2006, a similar number to the 67,752 deaths recorded in 1997 (52.4%). Females accounted for 65,183 deaths (48.7%) registered in 2006, an increase over the past decade from 61,598 (47.6%) deaths in 1997. The sex ratio (male deaths per 100 female deaths) has been gradually declining over the past decade, down from 110.0 in 1997 to 105.2 in 2006.

Causes of Death statistics, and the use of these statistics for demographic and health purposes, are key to understanding current and future pictures of Australian society and formulation and monitoring of policies. Causes of death information provide insights into the diseases and factors contributing to reduced life expectancy. Causes of death statistics are one of the oldest and most comprehensive set of health statistics available in Australia.

Causes of death data in this publication are classified using the 10th revision of the International Classification of Diseases (ICD) (see Explanatory Notes 30-33 for further information). This classification allows data to be presented at various levels of aggregation depending on the requirements of the data user. In this publication, data are presented in a number of ways to allow different types of analysis.

In this section, deaths are aggregated to present broad information about national health priority areas. This is followed by an analysis of leading causes of death at a more detailed level of ICD-10.

Underlying and Multiple Cause of Death

Causes of death statistics in Australia are recorded as both underlying cause i.e. the disease or injury which initiated the train of morbid events leading directly to death; and multiple cause i.e. all causes and conditions reported on the death certificate that contributed, were associated or was the underlying cause of the death (see Glossary for further details).

For the 133,739 deaths registered in Australia in 2006, there were 424,796 causes reported giving a mean of 3.2 causes per death. In 18.4% of all deaths, only one cause was reported, whereas 37.2% of deaths were reported with three or more causes. The mean number of causes reported per death varies with age, sex and underlying cause of death.

NATIONAL HEALTH PRIORITY AREAS

Australia's National Health Priority Areas are diseases and conditions given focused attention because of their significant contribution to the burden of illness and injury in the Australian community.

The seven priority areas are arthritis and musculoskeletal conditions, asthma, cancer control, cardiovascular health, diabetes mellitus, injury prevention and control, and mental health. In 2006, deaths associated with the seven National Health Priority Areas accounted for 77.4% of all underlying causes of death and were either associated with or the underlying cause of 90.8% of deaths.

Arthritis and Musculoskeletal Disease (M00-M99)

Arthritis and Musculoskeletal Diseases are conditions in which there is inflammation of the joints that can cause pain, stiffness, disability and deformity. It also includes other joint problems and disorders of the bones, muscles and their attachments. Diseases of the muscles, bones and tendons (M00-M99) was the underlying cause for 1,076 registered deaths in Australia in 2006. The prevalence of these diseases as an underlying cause has risen by 284 registered deaths from 1997, with an increase of 44 deaths from 2005. They have contributed to a total of 5,940 registered deaths in Australia in 2006.

Of all deaths due to these diseases in 2006, 747 or 69% were females, predominantly in the 75 - 94 year age group.

Arthritis (M00-M25) attributed to 35% of all deaths due to these diseases, with the most common age group for both males and females being 75-84 years.

The standardised death rates for Diseases of the muscles, bones and tendons were 3.6 per 100,000 for males, 5.6 per 100,000 for females and 4.8 per 100,000 for persons.

Asthma (J45-J46)

Asthma is a disease which causes narrowing of the airways into the lung causing breathing difficulties. In 2006, Asthma (J45-J46) was the underlying cause for 402 registered deaths. The number of deaths in which Asthma is the underlying cause has declined by 19.4% since 1997. The proportion of deaths due to Asthma has also declined over the last 10 years from 0.4% in 1997 to 0.3% in 2006. Asthma was identified as either an underlying cause or associated cause of death for 1,255 deaths registered in 2006.

Further analysis of registered deaths where Asthma was the underlying cause revealed that 99% of these were not specified as to whether or not they were attributed to allergic or non allergic asthma. It was the underlying cause of death for almost twice as many females as males in 2006 with 53 male deaths for every 100 female deaths.

The standardised death rates for Asthma were 1.5 per 100,000 for males, 2.0 per 100,000 for females and 1.8 per 100,000 for persons.

Cancer (C00-D48)

Cancer refers to a diverse group of diseases in which abnormal cells develop and divide uncontrollably and have the ability to infiltrate and destroy normal body tissue. Cancer can spread throughout the body causing further damage. In 2006 cancer was the underlying cause of death for 39,753 registered deaths in Australia. This accounted for 30% of all registered deaths. Cancer contributed to a total of 45,625 deaths as an underlying or associated cause of death.

More males than females died of cancer with 129 males deaths per 100 females deaths for the 2006 registration year. The median age of persons dying from cancer has continued to rise from 72.4 years in 1997 to 74.9 years in 2006.

Prostate cancer (C61) was the underlying cause of 4.3% of all male deaths registered in 2006. The median age at death for prostate cancer is 80.4 years. This is close to the median age for all deaths (80.3 years). Breast cancer (C50) was the underlying cause of 4.0% of all female deaths. The female median age at death was 68.3 years, which is 14.9 years lower than the median age for all female deaths (83.3 years). Years of potential life lost due to Prostate cancer for males was 10,129 and due to Breast Cancer was to 32,133 (See Technical Note for further information).

Seven of the top 20 leading underlying causes of death in 2006 were attributable to some form of malignant cancer. These seven causes accounted for 24,218 deaths or 18% of all registered deaths in 2006. Cancer of the digestive organs accounted for over a quarter of all cancer deaths (10,900 deaths).

The standardised death rates for Cancer were 231.7 per 100,000 for males, 143.2 per 100,000 for females and 180.9 per 100,000 for persons. The years of potential life lost were 181,412 for males and 148,035 for females.

Cardiovascular Disease (I00-I99)

Cardiovascular health relates to the health of the heart and blood vessels. The major underlying causes of death relating to cardiovascular health are coronary heart disease, stroke, heart failure and peripheral vascular disease. Diseases of the heart and blood vessels were the underlying cause for 45,670 registered deaths in Australia during 2006, of which, 47% were male and 53% were female. The median age at death for Diseases of the heart and blood vessels was 84.0 years, slightly higher than the median age for all deaths (80.3 years). These diseases contributed to a total of 76,928 deaths as an underlying or associated cause of death.

While this was the largest contributor (34%) to all deaths registered in the same year, the number of deaths due to this cause have continued to steadily decrease. In 1997, there were 53,636 registered deaths attributed to Diseases of the heart and blood vessels as the underlying cause, reflecting a decrease of 7,966 deaths over the past 10 years, and a decrease of 464 registered deaths from 2005.

The standardised death rates for these diseases were 236.9 per 100,000 for males, 171.5 per 100,000 for females and 201.9 per 100,000 for persons. The years of potential life lost were 118,382 for males and 48,705 for females.

Diabetes (E10-E14)

Diabetes is a disorder caused by the inability of the body to control the amount of sugar in the blood. If left untreated, diabetes can severely damage organs in the body. Diabetes (E10-E14) was the underlying cause for 3,662 registered deaths in Australia in 2006. This represented an increase of 133 registered deaths from the previous year, an increase of 543 over the past five years, and an increase of 631 deaths from 1997.

In 2006, Diabetes accounted for 2.7% of all registered deaths, an increase from 2.3% in 1997. Diabetes contributed to 12,832 deaths as an underlying or associated cause of death.

Type II diabetes (Non-insulin related diabetes) accounted for 1,519 or 42% of all diabetes deaths. This particular type of diabetes experienced the largest increase, rising by 424 deaths from 2001, and 642 deaths from 1997. It was more predominant in the 75-84 year age group for males, and the 85-94 year age group for females. These age groups also accounted for the largest increase in the number of deaths from the previous year. In 2006, the number of males aged 75-84 years who died due to Type II diabetes increased by 132 compared with 2005, and the number of females aged 85-94 years increased by 196 compared with 2005.

The standardised death rates for Diabetes were 19.5 per 100,000 for males, 14.0 per 100,000 for females and 16.4 per 100,000 for persons. The years of potential life lost were 10,593 for males and 6,782 for females.

Injuries (V01-Y98)

Injuries due to External causes of death, relate to cases where the underlying cause of death is determined to be one of a group of causes external to the body (for example suicide, transport accidents, falls, poisoning etc).

In 2006, External causes accounted for 7,840 deaths, or 5.9% of all registered deaths. The standardised death rate was 36.7 per 100,000 of population in 2006, a decrease from 38.4 in 2005 and from 43.3 per 100,000 population in 1997. Males were more likely to die from external causes than females in 2006. The standardised death rates for External Causes were 52.5 for males and 21.7 for females. The years of potential life lost were 161,807 for males and 50,871 for females.

Compared to women, more men at younger ages have died from External causes over time. Consistent with previous years, just over two-thirds of the total number of deaths resulting from External causes were males. The difference between the number of male and female deaths was most apparent amongst the 25-34 year age group, with 831 male deaths compared to 198 female deaths in 2006.

Transport accidents (V01-V99, Y85) accounted for 1,668 deaths, 21% of all deaths due to external causes. Of these, 1,262 (76%) were males and the remaining 406 (24%) were females. Transport accidents presented a younger profile in comparison to all external causes deaths, with a median age at death of 34.6 years for males, 41.4 years for females.

There were 1,799 deaths due to Intentional self-harm [suicide] (X60-X84, Y87.0) in 2006, which accounted for 23% of all deaths due to External causes. Of these deaths, 1,398 (78%) were of males and 401 (22%) were of females. The age-standardised suicide rate in 2006 was 13.6 per 100,000 males, 3.8 per 100,000 females and 8.6 per 100,000 people. The median age at death for Intentional self-harm was 43.9 years. Median age at death for males was 43.6 years, compared with 45.1 years for females.

Care should be taken in interpreting numbers of suicide deaths due to limitations in the data. For further information, see Explanatory Notes57-58 and 74-75.

Mental Health Disorders (F00-F99)

Deaths due to Mental health disorders relate to behaviours and conditions which interfere with social functioning and capacity to negotiate daily life. Deaths due to Mental and behavioural disorders (F00-F99) were identified as the underlying cause of 5,156 registered deaths, representing 3.9% of all registered deaths in Australia during 2006. This was an increase of 1,789 (53%) when compared with 2005. The prevalence of Mental Health and behavioural disorders as an underlying cause has increased significantly since 1997, with an increase of 2,271 (79%) deaths. In 2006, 18,943 deaths were due to, or associated with, Mental and behavioural disorders.

In 2006, more than twice as many females died due to Mental and behavioural disorders than males, with 64% of deaths (3,296) being of females. The median age at death was higher for females at 88.6 years, compared with 84.0 years for males.

Dementia (F01-F03) accounted for 89% of Mental and behavioural disorders in 2006. The sex ratio of 48.1 males per 100 female deaths has remained relatively steady since 1997 with 1,486 males and 3,090 females dying of this disease in 2006. The median age at death for persons (87.9 years) was higher than the median age for Mental and behavioural disorders (80.3 years) as a whole. For further information regarding Dementia, see Explanatory Note 66.

The standardised death rates for Mental and behavioural disorders were 21.4 per 100,000 males, 22.5 per 100,000 females and 22.4 per 100,000 persons. The years of potential life lost were 6,653 for males and 3,571 for females.

LEADING CAUSES OF DEATH

Ranking causes of death is a useful method of describing patterns of mortality in a population and allows comparison over time and between populations. However, different methods of grouping causes of death can result in a vastly different list of leading causes for any given population. The ranking of leading causes of death in this publication are based on research presented in the Bulletin of the World Health Organisation, Volume 84, Number 4, April 2006, 257-336 (see Explanatory Notes 46-48 for further information).

In 2006, the leading underlying cause of death for all Australians was Ischaemic heart diseases, which include angina, blocked arteries of the heart and heart attacks. Ischaemic heart diseases accounted for 18% of all male deaths, and 17% of all female deaths registered in 2006.

Ischaemic Heart Diseases have been the leading cause of death in Australia over the last 10 years, however the proportion of deaths attributed to Ischaemic heart diseases has declined from 23% in 1997 to 17% in 2006. The number of deaths due to this cause has also decreased (by 22% since 1997), down to 22,985 deaths in 2006 from 29,457 in 1997.

Cerebrovascular diseases, which include haemorrhages, strokes, Infarctions and blocked arteries of the brain has remained as the second leading underlying cause of death over the last 10 years. Deaths due to this cause have decreased marginally from 12,403 deaths in 1997 to 11,466 deaths in 2006. This represents a decline of 7.6% over that period. The proportion of all underlying deaths due to this cause has also declined from 9.6% in 1997 to 8.6% in 2006.

Lung cancer remains the third leading underlying cause of death since 1997. Deaths due to Lung cancer have increased in number from 6,588 deaths in 1997 to 7,348 deaths registered in 2006. This represents an 12% increase. These deaths accounted for 5.5% of all registered deaths (up from 5.1%).

Dementia and Alzheimer's disease related deaths have experienced the highest increase both numerically and proportionally, having risen by 3,249 deaths or 99% since 1997, when 3,294 registered deaths were attributed to this underlying cause. In 2006 this cause accounted for 6,543 deaths in 2006, has lead to it becoming Australia's 4th leading cause of death, up from 8th ranking in 1997.

(a) Based on research presented in the Bulletin of the World Health Organisation, Volume 84, Number 4, April 2006, pp. 257-336. For further information, see Explanatory Notes 46-48.

(b) Care should be taken in interpreting numbers of suicide deaths due to limitations in the data. For further information, see Explanatory Notes 57-58 and 74-75.

The top 10 leading causes of death accounted for 53.2% of all deaths registered in 2006.

Leading causes of death by gender

Ischaemic heart diseases were the leading cause of death for both males and females in 2006, with 12,187 and 10,798 deaths respectively, which reflects a sex ratio of 113 male deaths per 100 female deaths.

The leading underlying causes of death vary between the sexes. Many of the largest differences between genders are commonly attributed to the fact that the cause is gender-specific, eg. ovarian cancer, however, other causes which may not be gender-specific also experienced variances between the sexes.

Examples of these included:

Lung cancer, where there were 174 male deaths for every 100 females deaths;

Strokes, where there were 64 male deaths for every 100 females deaths;

Chronic lower respiratory diseases, where there were 118 male deaths for every 100 females deaths; and

Dementia and Alzheimer's disease, where there were 46 male deaths for every 100 females deaths.